Anti-Microbial Resistance Cause and Solution

Recently the National Centre for Disease Control (NCDC) in a study found that over half of the nearly 10,000 hospital patients surveyed were given antibiotics to prevent, rather than treat, infection.

What is Antimicrobial Resistance (AMR)?

Antimicrobials - including antibiotics, antivirals, antifungals and antiparasitic - are medicines used to prevent and treat infections in humans, animals and plants.

• It is defined as resistance of micro-organisms to an antimicrobial agent to which they were first sensitive.
• Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.
• Indian context- The present serious concern is that multiple types of bacteria like E. coli, Klebsiella, Acinetobacter, Staphylococcus aureus, enterococcus have even become resistant to some of the latest generation antibiotics.

• AMR causes higher mortality and morbidity due to drug resistant infections.

What are the key highlights of the report?

India carries one of the largest burdens of drug-resistant pathogens worldwide.

What are the causes of AMR?

The World Health Organization (WHO) included AMR as one of the top 10 threats to public health in 2019.

• Indiscriminate use- The inappropriate use of antibioticsin non-bacterial infections both because of prescribing practices and the use of over-the-counter antibiotics.
• Lack of research- Inadequate laboratory facilities to inform clinicians rapidly about what would be an appropriate antibiotic even in bacterial infections, based on cultures.
• Lack of capacity building- Due to lack of adequate training in antibiotic selection, escalation and de-escalation.
• Lack of regulation- Inadequate monitoring of AMR and control of antibiotic and dispensing practices by health systems in spite of repeated warnings.
• Market promotion- The pharmaceutical industry is incentivizing the antibiotic prescribing practices of doctors.
• Superbugs- Inappropriate use of antibiotics and other molecules used to treat or prevent infections in the human, animal and agricultural sectors generate bugs that are resistant to these drugs.
• Improper sanitation- This leads to the spread of superbugs due to inadequate infection prevention in healthcare institutions.
• Lack of support- AMR is a complex socio-economic and political challenge and not just a scientific issue, it needs support from the pharmaceutical industry, awareness to the patients etc.,
• Speedy treatment- The course of antibiotics is cheaper than the investigation of patients, which is time consuming.
• Infrastructural deficit- India lacks laboratories to speed up the patient’s investigation making it costly, which results in over prescription of antibiotics.

What is the way forward?

• Promote research- The need of the hour is linking labs to all levels of clinical setups and the fast transmission of infection-related data between the lab and the clinician.
• Holistic approach- The rate of AMR is directly proportional to steady and strong governance, infrastructure, sanitation, poverty, access to clean drinking water, etc.,
• Patient safety measures- The factors such as sanitation in hospitals, basic access to personal hygiene and infection control, are vital.
• Enhance infection prevention- The basic steps such as washing hands regularly, use of sanitizers helped a lot to keep the infection under control during COVID-19, such practices must be adopted to prevent AMR.